Fusarium rhinosinusitis post chimeric antigen receptor T-cell therapy

Area of Science:

• Oncology
• Infectious Diseases
• Immunotherapy

Background:

• Chimeric antigen receptor T-cell (CAR-T) therapy represents a significant advancement in treating hematologic malignancies.
• Patients undergoing CAR-T therapy are potentially susceptible to opportunistic infections due to lymphodepletion.
• Invasive fungal infections pose a serious risk in immunocompromised patients.

Purpose of the Study:

• To report a case of acute invasive fungal rhinosinusitis (AIFR) caused by Fusarium species in a patient post-CAR-T therapy.
• To illustrate the clinical, endoscopic, and histopathologic features of AIFR in this specific context.

Main Methods:

• Case presentation of a patient with refractory diffuse large B cell lymphoma.
• Detailed description of the diagnostic process, including clinical examination, endoscopy, and histopathology.
• Identification of the causative fungal species as Fusarium.

Main Results:

• The patient, treated with CAR-T therapy for refractory diffuse large B cell lymphoma, developed AIFR.
• Clinical, endoscopic, and histopathologic findings consistent with AIFR were observed.
• Fusarium species was identified as the causative agent.

Conclusions:

• CAR-T therapy can predispose patients to severe opportunistic infections like AIFR.
• Early recognition and diagnosis of AIFR are crucial in post-CAR-T patients.
• Comprehensive diagnostic methods are essential for identifying fungal infections in this vulnerable population.